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How to Get Better Sleep

Sleep is a critical part of overall health and well-being.

It is one of the three pillars of health, alongside diet/nutrition and exercise/activity. If you’re not getting enough sleep of sufficient quality, you are setting yourself up for worse mental and physical health. Sleep is a biological requirement for life – your body needs sleep to function. Sleep plays key roles in nearly every regulatory process in your body, which is why a lack of good quality sleep can lead to a long list of bad outcomes.
The American Academy of Sleep Medicine and Sleep Research Society recently came together to recommend that a typical healthy adult needs at least 7 hours of sleep at night to maintain optimal health and functioning. This recommendation is echoed by a number of other organizations, including the National Sleep Foundation, the American Heart Association, and others. What happens when you don’t get enough sleep? Insufficient sleep has been shown to lead to cardiovascular and metabolic risk factors like weight gain and obesity, high blood pressure, high cholesterol, diabetes, inflammation, heart attack, and stroke. It is also implicated in depression, stress, substance abuse, accidents, injuries, inability to focus, and decreased performance. Sleep is very important for the body, and a lack of sleep can affect daytime functioning in many ways.
Why don’t we get enough sleep? One reason is that we, as a society, don’t see sleep as important. Sleep is for the weak. Sleep is for people with too much free time. Sleep is for people who don’t have enough work to do. Right? We incentivize insufficient sleep in our society. At the population level, people tend to trade sleep for work time, rather than family time. In a sense, we are selling our sleep for social and financial rewards. But what are we getting for it? Research from our group and others shows that trading sleep for work time is not a good bargain. People who have more difficulties getting enough sleep are more likely to miss work, call out sick, underperform, have decreased productivity, and end up costing their employers more money in the long run in terms of decreased productivity and increased healthcare spending due to poorer health as a result of insufficient sleep. So giving up sleep for more work time actually makes you a worse employee, less productive, and more likely to underperform. Do you want to succeed? Get better sleep.
To get better sleep, there are three steps. First, you need to see if you have an untreated sleep disorder. Sleep disorders are quite common and often go undiagnosed. See a sleep specialist (we have several here at UA). Up to 10% of the adult US population meets criteria for an insomnia disorder (which will likely not go away on its own and could be a major health risk factor long-term). The recommended first-line treatment for insomnia, Cognitive Behavioral Therapy for Insomnia, does not involve medications, usually outperforms sleeping pills, and does not come with all of the medication side effects (and it was partially developed here at UA). Sleep apnea, a sleep disorder where you have trouble breathing during the night, is shockingly common in adults, especially men. Up to 10-20% of men over 30 probably have sleep apnea and most have no idea. Other sleep disorders should also be addressed.
Once you address an underlying sleep disorder, you can make sure that you are practicing healthy sleep habits. This is called “sleep hygiene” and can help you identify and remove obvious barriers to sleep. This means keeping a regular schedule, getting bright light during the day and avoiding bright light at night, avoiding caffeine, nicotine, and alcohol at night, keeping your bedroom cool, dark, and comfortable, avoiding excessive food or water before bed, and other general sleep tips like that. Other suggestions include getting electronic media (including the TV) out of the bedroom, avoiding naps if you have trouble getting to sleep, avoiding watching the clock at night, and getting plenty of exercise during the day. These may not fix a sleep problem, but they will help keep sleep problems from developing.
Finally, after you’ve addressed any underlying sleep disorders and after you’ve made sure that you’re engaging in healthy sleep habits, you can try to optimize your sleep. Set realistic goals for yourself, and don’t try to make too many large changes to your sleep at once. Keeping changes small will help you succeed – instead of looking for an extra hour of sleep, just see if you can find an extra 15 minutes. Allowing yourself enough time to wind down at night is key – most people expect to jump right to sleep when they get into bed, even though they didn’t give their mind 30-60 minutes to wind down, which is usually what we need. Sometimes, keeping track of your sleep schedule in a log or a diary can help you notice patterns and keep you on a regular schedule. Some people use fitness/sleep tracker devices to keep tabs on their sleep. Even though their accuracy isn’t perfect, they can still be useful.
Sleep is an important part of health and daytime functioning. Getting healthy sleep means dealing with untreated sleep disorders, practicing good sleep habits, and being serious about giving yourself enough time to get enough sleep. Here in Tucson, we are very fortunate to have one of the largest concentrations of sleep experts anywhere. Here at UA, we also have the Behavioral Sleep Medicine Clinic (focusing on non-medication treatments for sleep problems, especially insomnia) and the Sleep Disorders Center (focused on sleep apnea and other sleep disorders from a more medical perspective). Taking care of your sleep is important. Sleep is not unproductive time – during sleep, your body is very busy doing what it needs to do to keep you fit, functional, and focused. It’s time to make it more of a priority!

Michael A. Grandner, PhD, MTR, CBSM
Assistant Professor of Psychiatry, Psychology, and Medicine
Director, Sleep & Health Research Program
University of Arizona College of Medicine